Transplants: Indians to get preference over foreigners

Transplants: Indians to get preference over foreigners

Lakhs of foreigners thronging India every year seeking organ transplantation may find it difficult now. In an attempt to step up safeguards against misuse, the government has mandated that allocation of organs be made in a specified sequence giving preference to Indians over foreigners.

However, the medical fraternity has opposed the move alleging this will force doctors to differentiate between patients based on region and nationality, which is a violation of Medical Council of India (MCI) Act.

In a letter addressed to health secretary Lov Verma, Indian Medical Association (IMA) said, "Transplantation of Human Organs and Tissues Rules, 2014 are now been implemented and the rule 31 (4e) is a violation of MCI Act...the matter is a serious concern to the medical fraternity and needs immediate attention".

Recently, the Delhi government also issued an order to private hospitals asking them to obtain a no-objection certificate from at least two government hospitals with waiting lists-RP Centre (AIIMS) and Guru Nanak Eye Centre (MAMC)-before undertaking a transplant.

The move was triggered by aberrations found in cornea transplant. While the demand for cornea in India is very high, there are very few who manage to get it. Institutes like AIIMS usually have 500-600 waiting to get the tissue. Experts say, while inadequate donors is a major concern, often Indian patients in need do not get them in the absence of stringent law.

According to Organ Retrieval Banking Organization, a wing of AIIMS, over 1 lakh corneas are required every year, whereas only 25,000 are transplanted. Similarly, there is a need for 1-1.5 lakh kidneys per year but merely 3,500-4,000 transplants take place. For liver transplant, the need is 15,000 -20,000 every year but only around 500 take place.

However, doctors feel the organ allocation policy needs to be framed in a way that it doesn't discriminate between patients in need. Moreover, such a policy should ensure speedy procedure as organs may be wasted if not used within a specified time, says IMA secretary general Dr K K Aggarwal.

The government's move may also hurt various leading private hospitals who clock significant part of their international revenue from organ transplantation. With stricter norms and procedures, number of transplants in foreign patients may be impacted.

According to the Transplantation of Human Organs and Tissues Rules, 2014, in the chain of priority list, foreign nationals come at the end only after exhausting needs of Indian patients.

India's medical tourism industry is pegged at around $3 billion and growing at 20% a year. Leading hospital chains like Apollo, Medanta, Max and Ganga Ram attract patients mostly from Africa, CIS countries, Gulf and Saarc nations, Pakistan, Bangladesh and Myanmar. According to officials from these hospitals, patients primarily come for organ transplants, oncology-related treatment and cardiac and orthopedic surgeries.